Scapulothoracic bursitis

Last revised by Yuranga Weerakkody on 5 Apr 2022

Citation, DOI, disclosures and article data

Citation:

Matic M, Weerakkody Y, Knipe H, et al. Scapulothoracic bursitis. Reference article, Radiopaedia.org (Accessed on 16 Apr 2024) https://doi.org/10.53347/rID-79859

DOI:

https://doi.org/10.53347/rID-79859

Permalink:

https://radiopaedia.org/articles/79859

rID:

79859

Article created:

7 Jul 2020, Marko Matic

Disclosures:

At the time the article was created Marko Matic had no recorded disclosures.

View Marko Matic's current disclosures

Last revised:

5 Apr 2022, Yuranga Weerakkody ◉

Disclosures:

At the time the article was last revised Yuranga Weerakkody had no recorded disclosures.

View Yuranga Weerakkody's current disclosures

Revisions:

9 times, by 6 contributors - see full revision history and disclosures

Systems:

Musculoskeletal

Tags:

rg_41_2_edit, cases

Synonyms:

Scapulothoracic bursitides
Scapulothoracic bursal inflammation

Scapulothoracic bursitis (rare plural: scapulothoracic bursitides) is defined by inflammation of the scapulothoracic bursae.

The constellation of symptoms arising from scapulothoracic bursitis is commonly referred to as snapping scapula syndrome ¹, although there are other causes of this syndrome ⁴. If this occurs in the context of mechanical symptoms, it is called scapulothoracic crepitus. The distinction is often clinically difficult, as symptomatic bursitis can manifest as mechanical crepitus, and vice versa ¹.

Clinical presentation

Patients typically present with pain (at the superomedial angle or inferior scapular pole) during overhead activity, or repetitive shoulder movement ². This may be accompanied by audible or palpable crepitus with scapular movement or localized swelling.

Pathology

Bursitis generally occurs as a result of acute trauma, or in chronic overuse (especially if there is underlying anatomic predisposition). Most cases result from abnormal scapular kinematics, leading to chronic inflammation ¹.

Radiographic features

Plain radiograph

Useful in identifying osseous lesions (most commonly osteochondromas) or skeletal abnormality.

Standard shoulder series (AP and lateral) and an axillary view recommended.

CT

Not routinely indicated unless skeletal lesion or joint incongruity demonstrated. Utility in further characterizing bony morphology and potential surgical planning.

MRI

Signal characteristics include

T1: homogenous isointense lesion, between serratus anterior muscle and the chest wall ³
T2: high signal intensity
T1C+ (Gd): moderate peripheral enhancement

Treatment and prognosis

Treatment is generally conservative in the absence of suspected malignancy, significant skeletal abnormality or a space-occupying lesion; NSAIDs, rehabilitation and physiotherapy, postural training and activity modification. Refractory cases may warrant local therapeutic injections or surgery (i.e. bursectomy or osseous resection) ¹.